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Nodal Differentiated Thyroid Carcinoma
Patricia A. Hudgins, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Differentiated thyroid carcinoma (DTC)
                • Papillary thyroid carcinoma (PTC)
              • Definitions

                • Metastatic node(s) from papillary or follicular thyroid carcinoma
                  • Papillary = 80-90% thyroid malignancies
                  • Follicular = 5% thyroid malignancies

              IMAGING

              • General Features

                • Imaging Recommendations

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nuclear Medicine Findings

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Lan X et al: A Meta-analysis of central lymph node metastasis for predicting lateral involvement in papillary thyroid carcinoma. Otolaryngol Head Neck Surg. ePub, 2015
                                            2. Wei T et al: Predictive factors of contralateral paratracheal lymph node metastasis in unilateral papillary thyroid carcinoma. Eur J Surg Oncol. 41(6):746-50, 2015
                                            3. Wu MH et al: Prognostic significance of extranodal extension of regional lymph node metastasis in papillary thyroid cancer. Head Neck. 37(9):1336-43, 2015
                                            4. Yeh MW et al: American Thyroid Association statement on preoperative imaging for thyroid cancer surgery. Thyroid. 25(1):3-14, 2015
                                            5. Coquia SF et al: The role of sonography in thyroid cancer. Radiol Clin North Am. 52(6):1283-94, 2014
                                            6. Mizrachi A et al: Value of ultrasound in detecting central compartment lymph node metastases in differentiated thyroid carcinoma. Eur Arch Otorhinolaryngol. 271(5):1215-8, 2014
                                            7. Su HK et al: Striving toward standardization of reporting of ultrasound features of thyroid nodules and lymph nodes: a multidisciplinary consensus statement. Thyroid. 24(9):1341-9, 2014
                                            8. Vannucchi G et al: Ultrasound-guided percutaneous ethanol injection in papillary thyroid cancer metastatic lymph-nodes. Endocrine. 47(2):648-51, 2014
                                            9. Wang LY et al: Central lymph node characteristics predictive of outcome in patients with differentiated thyroid cancer. Thyroid. 24(12):1790-5, 2014
                                            10. Xiang D et al: Contrast-enhanced ultrasound (CEUS) facilitated US in detecting lateral neck lymph node metastasis of thyroid cancer patients: diagnosis value and enhancement patterns of malignant lymph nodes. Eur Radiol. 24(10):2513-9, 2014
                                            11. Giacomini CP et al: Ultrasonographic evaluation of malignant and normal cervical lymph nodes. Semin Ultrasound CT MR. 34(3):236-47, 2013
                                            12. Li QK et al: Thyroglobulin measurements in fine-needle aspiration cytology of lymph nodes for the detection of metastatic papillary thyroid carcinoma. Cancer Cytopathol. 121(8):440-8, 2013
                                            13. Shin LK et al: Sonographic evaluation of cervical lymph nodes in papillary thyroid cancer. Ultrasound Q. 29(1):25-32, 2013
                                            14. Kaplan SL et al: The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol. 30(3):608-12, 2009
                                            15. Lim YC et al: Central lymph node metastases in unilateral papillary thyroid microcarcinoma. Br J Surg. 96(3):253-7, 2009
                                            16. Lim YC et al: Occult lymph node metastases in neck level V in papillary thyroid carcinoma. Surgery. Epub ahead of print, 2009
                                            17. Rotstein L: The role of lymphadenectomy in the management of papillary carcinoma of the thyroid. J Surg Oncol. 99(4):186-8, 2009
                                            18. Schmidt D et al: Impact of 131I SPECT/spiral CT on nodal staging of differentiated thyroid carcinoma at the first radioablation. J Nucl Med. 50(1):18-23, 2009
                                            19. Roh JL et al: Central cervical nodal metastasis from papillary thyroid microcarcinoma: pattern and factors predictive of nodal metastasis. Ann Surg Oncol. 15(9):2482-6, 2008
                                            20. Roh JL et al: Lateral cervical lymph node metastases from papillary thyroid carcinoma: pattern of nodal metastases and optimal strategy for neck dissection. Ann Surg Oncol. 15(4):1177-82, 2008
                                            21. Soler ZM et al: Utility of computed tomography in the detection of subclinical nodal disease in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 134(9):973-8, 2008
                                            22. Sugitani I et al: Prospective outcomes of selective lymph node dissection for papillary thyroid carcinoma based on preoperative ultrasonography. World J Surg. 32(11):2494-502, 2008
                                            23. Yanir Y et al: Regional metastases in well-differentiated thyroid carcinoma: pattern of spread. Laryngoscope. 118(3):433-6, 2008
                                            24. Leboulleux S et al: Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab. 92(9):3590-4, 2007
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Differentiated thyroid carcinoma (DTC)
                                                          • Papillary thyroid carcinoma (PTC)
                                                        • Definitions

                                                          • Metastatic node(s) from papillary or follicular thyroid carcinoma
                                                            • Papillary = 80-90% thyroid malignancies
                                                            • Follicular = 5% thyroid malignancies

                                                        IMAGING

                                                        • General Features

                                                          • Imaging Recommendations

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Nuclear Medicine Findings

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Lan X et al: A Meta-analysis of central lymph node metastasis for predicting lateral involvement in papillary thyroid carcinoma. Otolaryngol Head Neck Surg. ePub, 2015
                                                                                      2. Wei T et al: Predictive factors of contralateral paratracheal lymph node metastasis in unilateral papillary thyroid carcinoma. Eur J Surg Oncol. 41(6):746-50, 2015
                                                                                      3. Wu MH et al: Prognostic significance of extranodal extension of regional lymph node metastasis in papillary thyroid cancer. Head Neck. 37(9):1336-43, 2015
                                                                                      4. Yeh MW et al: American Thyroid Association statement on preoperative imaging for thyroid cancer surgery. Thyroid. 25(1):3-14, 2015
                                                                                      5. Coquia SF et al: The role of sonography in thyroid cancer. Radiol Clin North Am. 52(6):1283-94, 2014
                                                                                      6. Mizrachi A et al: Value of ultrasound in detecting central compartment lymph node metastases in differentiated thyroid carcinoma. Eur Arch Otorhinolaryngol. 271(5):1215-8, 2014
                                                                                      7. Su HK et al: Striving toward standardization of reporting of ultrasound features of thyroid nodules and lymph nodes: a multidisciplinary consensus statement. Thyroid. 24(9):1341-9, 2014
                                                                                      8. Vannucchi G et al: Ultrasound-guided percutaneous ethanol injection in papillary thyroid cancer metastatic lymph-nodes. Endocrine. 47(2):648-51, 2014
                                                                                      9. Wang LY et al: Central lymph node characteristics predictive of outcome in patients with differentiated thyroid cancer. Thyroid. 24(12):1790-5, 2014
                                                                                      10. Xiang D et al: Contrast-enhanced ultrasound (CEUS) facilitated US in detecting lateral neck lymph node metastasis of thyroid cancer patients: diagnosis value and enhancement patterns of malignant lymph nodes. Eur Radiol. 24(10):2513-9, 2014
                                                                                      11. Giacomini CP et al: Ultrasonographic evaluation of malignant and normal cervical lymph nodes. Semin Ultrasound CT MR. 34(3):236-47, 2013
                                                                                      12. Li QK et al: Thyroglobulin measurements in fine-needle aspiration cytology of lymph nodes for the detection of metastatic papillary thyroid carcinoma. Cancer Cytopathol. 121(8):440-8, 2013
                                                                                      13. Shin LK et al: Sonographic evaluation of cervical lymph nodes in papillary thyroid cancer. Ultrasound Q. 29(1):25-32, 2013
                                                                                      14. Kaplan SL et al: The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol. 30(3):608-12, 2009
                                                                                      15. Lim YC et al: Central lymph node metastases in unilateral papillary thyroid microcarcinoma. Br J Surg. 96(3):253-7, 2009
                                                                                      16. Lim YC et al: Occult lymph node metastases in neck level V in papillary thyroid carcinoma. Surgery. Epub ahead of print, 2009
                                                                                      17. Rotstein L: The role of lymphadenectomy in the management of papillary carcinoma of the thyroid. J Surg Oncol. 99(4):186-8, 2009
                                                                                      18. Schmidt D et al: Impact of 131I SPECT/spiral CT on nodal staging of differentiated thyroid carcinoma at the first radioablation. J Nucl Med. 50(1):18-23, 2009
                                                                                      19. Roh JL et al: Central cervical nodal metastasis from papillary thyroid microcarcinoma: pattern and factors predictive of nodal metastasis. Ann Surg Oncol. 15(9):2482-6, 2008
                                                                                      20. Roh JL et al: Lateral cervical lymph node metastases from papillary thyroid carcinoma: pattern of nodal metastases and optimal strategy for neck dissection. Ann Surg Oncol. 15(4):1177-82, 2008
                                                                                      21. Soler ZM et al: Utility of computed tomography in the detection of subclinical nodal disease in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 134(9):973-8, 2008
                                                                                      22. Sugitani I et al: Prospective outcomes of selective lymph node dissection for papillary thyroid carcinoma based on preoperative ultrasonography. World J Surg. 32(11):2494-502, 2008
                                                                                      23. Yanir Y et al: Regional metastases in well-differentiated thyroid carcinoma: pattern of spread. Laryngoscope. 118(3):433-6, 2008
                                                                                      24. Leboulleux S et al: Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab. 92(9):3590-4, 2007